The IRG Report


23

Feb 2017

CMS Announces Proposed Rule on Orthotics and Prosthetics Qualified Providers

On January 11th, 2017, CMS released a proposed rule (CMS-6012-P) which would have a significant impact on eligible professionals who furnish custom-fabricated orthotics and prosthetics.  The rule, titled “Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom Fabricated Orthotics,” removes exemptions to quality standards and orthotic certification for OTs and PTs, and...

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19

Dec 2016

Recent Legislation Includes Limited Locum Tenens Provision for Physical Therapists

The 21st Century Cures Act, which was passed by the House and Senate earlier this month and signed into law by President Obama on December 13th, includes a provision which will allow physical therapists to enter into locum tenens arrangements and bring in another licensed physical therapist to treat Medicare patients and bill through the practice provider number during temporary...

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25

Nov 2016

Preparing for the New Therapy Evaluation Codes

The time is now to start preparing for the new evaluation and re-evaluation codes that will go into effect on January 1st, 2017.  As mentioned in the previous blog post, the current PT and OT evaluation and re-evaluation codes have been removed from the AMA CPT manual and replaced with three new evaluation codes and one new re-evaluation code for...

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13

Oct 2016

New Evaluation and Re-Evaluation Codes Are Coming in 2017

Drastic changes are coming to evaluation and re-evaluation codes for physical and occupational therapy in 2017.  As of January 1st, 2017, the current evaluation and re-evaluation codes (97001, 97002, 97003, and 97004) will be removed from the CPT code list and replaced with three new evaluation codes for both PT and OT along with one new re-evaluation code for each discipline. ...

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24

Sep 2016

South Carolina Supreme Court Overturns Ban on Integration of Physician and PT Services

The South Carolina Supreme Court has overturned a previous ruling which prohibited physicians from employing physical therapists in the Palmetto State.  Issued on September 14th, the Court’s decision in Joseph et al v South Carolina Department of Licensing, Labor, and Regulation, South Carolina Board of Physical Therapy concludes the decade-long fight over physician employment of PTs by overruling the Court’s 2006...

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30

Jun 2016

CMS Partners with StrategicHealthSolutions to Perform Targeted Manual Medical Reviews

The Centers for Medicare & Medicaid Services (CMS) has contracted with StrategicHealthSolutions, a Supplemental Medical Review/Specialty Contractor (SMRC) to assist with lowering improper payment rates and increasing efficiencies of the medical review functions of the Medicare and Medicaid programs, including the manual medical review process for therapy expenditures above the $3,700 therapy thresholds.  As you may recall, the Medicare Access...

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31

May 2016

Assessing Your Physical Therapy Practice: Do You Know What You Don’t Know?

We continually have the opportunity to meet and interact with physician practice administrators and physical therapy clinic directors from all over the country.  A common phrase we often hear when the conversation turns to their therapy clinic’s performance is, “We THINK we’re doing OK, but we don’t really know what we don’t know”.  Today, we’ll review some of the key...

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31

May 2016

Clinical Outcomes Part 3: Patient-Reported Outcome Measures (PROMs) in Therapy

It is becoming increasingly rare to pick up a journal or participate in an alternative payment model webinar that doesn’t mention Patient-Reported Outcome Measures (PROMs) as a key element in the transition toward outcome-based reimbursement.  While the PROM acronym may be relatively new to therapy providers, the practice of using patient-reported measures to help quantify patient progression has been on...

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05

Apr 2016

Clinical Outcomes Part 2: Deciding What to Measure

This post is the second in a series aimed at the capture, reporting, and relevance of clinical outcomes in the outpatient physical therapy environment.  In the previous blog post, I talked a little about the role that outcomes will play in a value-based reimbursement environment as well as the importance of outcomes in managing your clinic and in helping to...

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